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1427007293
MATTHEW A CLISSOLD
LOGAN, UT
NPI
1427007293
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207L00000X Anesthesiology
(Licence: UT 178712-1205)
Enumeration Date
2006-05-09
Last Update Date
2007-07-08
Business Address
-- MATTHEW A CLISSOLD M.D.
274 N MAIN ST
LOGAN, UT 84321-3915
Phone number: 435-753-1600
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Mailing Address
-- MATTHEW A CLISSOLD M.D.
274 N MAIN ST
LOGAN, UT 84321-3915
Phone number: 435-753-1600
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